Visiting Friends or Relatives in a Foreign Country
People who are traveling to a foreign country to visit friends or relatives (called “VFR travelers” by some professionals) are at higher risk for some diseases. The risk is higher because VFR travelers generally stay longer than tourists, eat local food in people’s homes, and may not take the same precautions (such as preventing bug bites) as tourists do. VFR travelers often do not see a doctor for vaccines and advice before they travel, possibly because of cost, cultural or language barriers, or limited time. If you are planning to travel overseas to visit friends or relatives, consider your increased risk of illnesses and plan accordingly.
VFR travelers are 8–10 times as likely to be infected with malaria as tourists, and in recent years, several VFR travelers have died of malaria after they returned to the United States. Many VFR travelers assume they are immune to malaria if they were born or lived a long time in a country with malaria, but any immunity disappears quickly after a person moves away. If you are going to a country with malaria, take malaria-prevention medicine according to your doctor’s instructions, even if your friends and relatives who still live in the country do not.
VFR travelers may think they can buy malaria medicine or other medicine more cheaply in the country they are visiting. However, you need to start taking malaria pills before you leave the United States in order to be protected. In addition, any medicine you buy outside the United States may be counterfeit—it may not have any active ingredients, or it may contain harmful substances. It’s often impossible to tell real and counterfeit medicines apart, so bring all your medicine from the United States.
Illnesses spread through contaminated food are common in VFR travelers, who often feel pressure to eat what they are served by family or friends. VFR travelers also do not have the same immunity to local bacteria as their friends and relatives do. Some foodborne illnesses, such as hepatitis A and typhoid, can be prevented with vaccines, but many others cannot. See a doctor before you travel to get any vaccines you may need, but also be very careful about what you eat and drink. In general, food that is cooked and served hot is safe to eat, and beverages from sealed containers are safe to drink. Avoid food served at room temperature, raw fruits or vegetables (unless they can be peeled), tap water, and ice made from tap water.
Other health considerations for VFR travelers include dengue and other infections spread by mosquitoes as well as parasites in water, tuberculosis, and sexually transmitted diseases. Before your trip, consult a travel medicine specialist who can give you customized advice on staying safe and healthy at your destination. At this consultation, you may be advised to use insect repellent, avoid swimming in fresh water, and take other steps to help you enjoy your visit without worrying about getting sick or injured.